Apport du scanner cardiaque dans la prise en charge des cardiopathies congénitales : expérience de l'institut de cardiologie d'Abidjan à propos de 27 cas

Ami Echua Manzan Avoh , Yves N'da Kouakou N'goran , Marie Paul N'cho-Mottoh , Diaby Fatou Traore , Micesse Tano-Akoto , Cedrick Zole Doh , Legre Vy , Kacou Jean-Baptiste Anzouan , Kouadio Euloge Kramoh
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Abstract

Introduction and objectives

In contrast to developed countries, cardiac CT is not widely used in West Africa for the assessment of congenital heart disease, and has only recently been introduced in Côte d'Ivoire. The lack of data prompted this study, the aim of which was to describe our experience of the contribution of CT to the management of congenital heart disease in the Ivorian cardiology setting.

Patients and method

This was a prospective study which took place in the pediatric cardiology department over a period of 9 months (September 2022 to June 2023) which included all patients with congenital heart disease explored by echocardiography and cardiac scan.

Results

The average age was 5.7 ± 4.7 years with extremes of 5 months and 16 years. We noted a female predominance with a sex ratio of 0.52. The main heart diseases were: tetralogy of Fallot (37.1%), followed by pulmonary atresia with open septum (18.52%). The assessment of the anatomy of the pulmonary arteries (81.48%), the search for aortopulmonary collaterals (59.63%) and finally the assessment of the anatomy of the aorta (18.52%) were the main indications. The practice of cardiac CT scanning has enabled better accuracy in the diagnosis and management of congenital heart disease in several cases: an interruption of the aortic arch was found in 1 case initially suspected of hypoplasia of the aortic arch, three cases of partial abnormal pulmonary venous return and one case of total abnormal pulmonary venous return. Also, agenesis of the left pulmonary artery with birth anomaly of the right coronary artery in the assessment of tetralogy of Fallot was found in 1 case. The CT scan made it possible to specify the exact topography of the aortopulmonary collaterals in four cases of pulmonary atresia with an open septum.

Conclusion

CT has enabled better visualization of the arterial and venous pulmonary tree, identification and exact localization of aorto-pulmonary collaterals, precise description of the three-dimensional anatomy of the coronary arteries, and better precision of congenital anomalies of the aorta.

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心脏 CT 在先天性心脏病治疗中的贡献:阿比让心脏研究所在 27 个病例中的经验
导言和目的与发达国家相比,心脏 CT 在西非并没有被广泛用于评估先天性心脏病,科特迪瓦也是最近才引入 CT。患者和方法这是一项前瞻性研究,在小儿心脏科进行,为期 9 个月(2022 年 9 月至 2023 年 6 月),包括所有通过超声心动图和心脏扫描检查的先天性心脏病患者。结果平均年龄为 5.7 ± 4.7 岁,最大年龄为 5 个月和 16 岁。我们注意到女性居多,性别比为 0.52。主要的心脏疾病有:法洛氏四联症(37.1%),其次是肺动脉闭锁伴房间隔开放(18.52%)。评估肺动脉的解剖结构(81.48%)、寻找主动脉肺动脉袢(59.63%)和评估主动脉的解剖结构(18.52%)是主要的适应症。心脏 CT 扫描的应用使一些先天性心脏病的诊断和治疗更加准确:1 例最初怀疑主动脉弓发育不良的病例发现主动脉弓中断,3 例部分肺静脉回流异常,1 例完全肺静脉回流异常。此外,在评估法洛氏四联症时发现 1 例左肺动脉发育不全,右冠状动脉先天异常。结论 CT 使肺动脉和肺静脉树的可视化程度更高,可识别并准确定位主动脉-肺动脉袢,精确描述冠状动脉的三维解剖结构,并能更准确地诊断先天性主动脉异常。
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来源期刊
CiteScore
0.60
自引率
0.00%
发文量
68
审稿时长
6-12 weeks
期刊介绍: Organe scientifique de référence fondé en 1951, les Annales de cardiologie et d''angéiologie abordent tous les domaines qui intéressent quotidiennement les cardiologues et les angéiologues praticiens : neurologie et radiologie vasculaires, hémostase, diabétologie, médecine interne, épidémiologie et prévention. Les Annales de cardiologie et d''angéiologie sont indexées aux grandes bases de données et publient rapidement, et en conformité avec les normes internationales de publication scientifique, des articles en français sur la pathologie cardiaque.
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